Right. So those would be all unreal, correct? They still fit your definition of hallucination: False sensory perception occurring in the absence of any relevant external stimulation of the sensory modality involved...So I still fail to understand what you meant when you said:

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if the voice is mainly heard during prayer/meditation/spiritual exercises and is congruent with the person's religious beliefs, it's probably not a true hallucination.

The paragraph I quoted distinguished between "true hallucinations" and "illusions, hypnagogic and hypnopompic hallucinations, and vivid imaginings." I said that I felt they fit the latter better than the former.

Did that clarify it better?

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It's your example, Mooby: a person says they're hearing a physical voice. There are only two options: the voice is real (external), or it isn't. Whether a person is praying or meditating at the time seems irrelevant.

Both the text I quoted and my training say that the situations in which hallucinations occur are an important thing to establish. You're looking at this from a different perspective, I think. You're looking for a way to label religious experience as hallucination, while I'm looking to treat the patient.

For instance, you might say, "There are only two options: either it's a stroke or it isn't. Whether that's caused by a bleed or a clot seems irrelevant." Well yes, it's irrelevant to someone looking to apply the label of stroke. It's certainly not irrelevant to someone who's deciding whether to give a clot-busting drug, since giving a clot busting drug to a person who's actively bleeding is like trying to put out a fire with gasoline.

HAL's OP asks what a doctor would think and do. And a doctor would ask a thorough history. If you tell me, "I hear a voice," I don't just say, "You're hallucinating, here's a pill." Instead, I'm going to spend the next few minutes asking you a ton of questions so I can get the most specific description I can of what you're experiencing, so that I can hopefully narrow my list down to maybe a half dozen things that are causing you to hear a voice.

The thing is, whether a person is praying or meditating is extremely relevant. Because if the person only hears the voice when in a trance-like state, it probably doesn't need treatment, unless the content is concerning or it's negatively affecting the patient's life.

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Yes it is. Doctors pass judgment all the time. Here in the UK, you can be locked up in a hospital on the word of two doctors. If they judge that you're crazy enough.

The colon indicated that I was speaking of judgment on the patients' beliefs or values. Not clinical judgment.

"Accepted delusion?" You're no longer talking medically. There's no such thing as an accepted delusion.

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The God Delusion is a 2006 bestselling[1] non-fiction book by English biologist Richard Dawkins, professorial fellow of New College, Oxford,[2][3] and inaugural holder of the Charles Simonyi Chair for the Public Understanding of Science at the University of Oxford.

In The God Delusion, Dawkins contends that a supernatural creator almost certainly does not exist and that belief in a personal god qualifies as a delusion, which he defines as a persistent false belief held in the face of strong contradictory evidence. He is sympathetic to Robert Pirsig's statement in Lila that "when one person suffers from a delusion it is called insanity. When many people suffer from a delusion it is called religion."[4]

Yes! We know that Endorphins, Dopamine, and Serotonin cause euphoria, Dopamine's in particular are what we find in abundance in methamphetamine it is what the user calls a "high". Serotonin is the chemical we find in antidepressants, These drugs are known as SSRI - Selective Serotonin Re-uptake Inhibitors. They work by blocking the sending neuron, thereby increasing the available serotonin levels in the synapse.

Yes, these things have been shown to be involved in religious or spiritual activities. Indeed, they are modulated in many activities of our daily lives. But of course, day to day fluctuations generally are physiological,

Yes! unless they are over stressed, excited, incited/stimulated. Then they can become pathological. You've only to look at theistic history to see that. Or any history where the masses are excited to a frenzy.

However, you likened religious experiences to "partaking in drugs or alcohol" and potentially leading to people becoming "mentally unsound and extremely dangerous." It was this pathologic change to which I was directing my inquiries. After all, if religious belief causes severe enough changes that it should be regarded as potentially detrimental to function as a drug or alcohol addiction, then given the prevalence of belief I'd think that it'd certainly be an important and exciting area for medical research. Don't you agree?

Theistic history show the results already. No need for more abortion centre, or twin towers and London buses to be blown up just to verify the cause, we know the cause already.

So what. Whats your point, I didn't say I would blatantly state to the person it was due to their drug, alcohol, theist addiction. They would be discarded from my employ for a completely different reason, though the main factor would be their addition.

The point was to assess your level of bigotry so I can take it into account in future replies to you.

No bigotry here, to be a bigot I would have to have a complete intolerance of any creed, belief, or opinion, that I don't have, I'm simply not going to put my workforce in danger, that’s not bigotry that’s good sense.

Checking to see whether you exercise it in ignorance or defiance of your country's laws was an easy way to do that.

In this country if I employed a person, and later found them drinking or taking drugs on the job, I could instantly fire them, I Just save myself that problem and I go one better, by including theism, as that can also be just as dangerous to my workforce. Better to not have it than for it to cause damage later, forewarned is forearmed. After all.

In what way can you demonstrate whether that voice is real or imaginary, if you can't demonstrate it is real then your only course of action is to see it as imaginary?

It's not up to a physician to determine whether the patient is hearing a deity's voice. There are religious ministers to assist with that. As I mentioned above, I'd be focusing on context and content. Is the voice more consistent with the normal spectrum of religious experiences and practices, or is it more consistent with pathology?

I think you're confusing the physician's role in this. A physician is not supposed to project his or her personal values onto the patient's condition. Their job is to properly diagnose and treat the patient. "I believe in God so the voice is real" and "I don't believe in God so the voice is imaginary" do not accomplish that.

Severe case of dodging, I repeat In what way can you demonstrate whether that voice is real or imaginary, if you can't demonstrate it is real then your only course of action is to see it as imaginary? It is after all real or it's not. Having a physician to verify that is moot.

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We theists have no evidence for our beliefs. So no amount of rational evidence will dissuade us from those beliefs. - JCisall

It would be pretty piss poor brainwashing, if the victims knew they were brainwashed, wouldn't it? - Screwtape. 04/12/12

Theistic history show the results already. No need for more abortion centre, or twin towers and London buses to be blown up just to verify the cause, we know the cause already.

You may feel you know the cause, but medical practice is (or at least should be) based on standard of care and evidence-based medicine. Managing religious patients the same as those recovering from addiction is not standard of care. And for evidence based practice, we look to the medical literature, not "theistic history." Randomized, controlled studies are the gold standard, but even case studies can give some hints of which future modalities may be useful.

When deciding whether to alter their approach to religious patients, which specific studies should physicians review?

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Severe case of dodging, I repeat In what way can you demonstrate whether that voice is real or imaginary, if you can't demonstrate it is real then your only course of action is to see it as imaginary? It is after all real or it's not. Having a physician to verify that is moot.

Dodging? The topic of this thread has been about how a doctor (particularly a psychiatrist) should evaluate a patient. I have been replying in every post so far as a doctor. How am I supposed to read your mind to know that you suddenly decided to go off topic?

In accordance with that, whether a physician can verify it and/or treat it as valid is the entire topic of this thread. So no, it is not moot.

Theistic history show the results already. No need for more abortion centre, or twin towers and London buses to be blown up just to verify the cause, we know the cause already.

You may feel you know the cause, but medical practice is (or at least should be) based on standard of care and evidence-based medicine. Managing religious patients the same as those recovering from addiction is not standard of care.

That is only because religion has been given a free pass, in regard to mental health

Severe case of dodging, I repeat In what way can you demonstrate whether that voice is real or imaginary, if you can't demonstrate it is real then your only course of action is to see it as imaginary? It is after all real or it's not. Having a physician to verify that is moot.

Dodging? The topic of this thread has been about how a doctor (particularly a psychiatrist) should evaluate a patient. I have been replying in every post so far as a doctor.

So what. if you can't demonstrate it is real then your only course of action is to see it as imaginary? regardless of your being a doctor or a layman.

Mooby why does a Christian need to seek a doctor for any medical ailments,be it life threatening or for mental health reasons? Pray and if its God's will you get better then so be it,if you die or go insane....also God's will

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There's no right there's no wrong,there's just popular opinion (Brad Pitt as Jeffery Goines in 12 monkeys)

Bertaberts,we should also ask if God's voice they hear is telling them to kill their children is real (as many cases of child killing) is a result of God or insanity? How in fact can you tell the difference?

Suppose a Christian went to a psychiatrist for evaluation, but the Christian talked in a manner that didn't make it obvious that they were a Christian, like this -...My question is, what does the doctor make of this person at this point. Does the doctor, because the patient now reveals they are a theist, simply say everything is OK? Why does admitting being a theist make it not a mental disorder to talk to an invisible man, if you say the doctor isn't concerned?

If the doctor thinks it is a mental disorder, how is it treated? What drugs would he prescribe for this mental condition?

This has actually been addressed by Canada's psychiatric authority (I once had a link, and then lost it): the conclusion is that if a sufficient large number of the population exhibit a delusion, it cannot be classed as a mental illness because it can be said to be "normal".

As examples, if someone refuses to walk under ladders as it is "bad luck", or that pine cones foretell the weather, or anyone of thousands of superstitions, then this is not considered an abnormality.

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Nobody says “There are many things that we thought were natural processes, but now know that a god did them.”

This has actually been addressed by Canada's psychiatric authority (I once had a link, and then lost it): the conclusion is that if a sufficient large number of the population exhibit a delusion, it cannot be classed as a mental illness because it can be said to be "normal".

Bertaberts,we should also ask if God's voice they hear is telling them to kill their children is real (as many cases of child killing) is a result of God or insanity? How in fact can you tell the difference?

Indeed. It seems that if the delusion is not too "bothersome" then we just let it slide. Somebody hears voices from god telling then to help feed the starving children in Africa and it's so amazing! What a nice message from god!

Oh dear, but when the delusion starts to get a little serious, like hearing voices from god telling believers to kill abortion doctors, the tune is changed. All of a sudden it's a "medical condition" requiring serious treatment. What a crock of horeseshit! Voices from god are voices from god - either it's delusonal or it's real. Since there is no objective way to show they are real, well you know what happens after that.

What's a delusion?

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delusion

3. Psychiatry A false belief strongly held in spite of invalidating evidence, especially as a symptom of mental illness: delusions of persecution.

Religious delusion is a type of cognitive phenomena known to psychiatry. Thoughts, either beliefs or ideas, that are found in psychosis have no basis in reality, and held with certainty and maintained by the person i.e. they are resistant to criticism (incorrigible) (Jaspers) that are additionally specifically of a type that is of the aspect or factor of reality defined as religious.[1][2]

Historically, Freud stated in an essay of 1937 that he considered the holding of belief in a single god to be a delusion,[1] which is an extension of his comments of 1907 that religion is the indication of obsessional neurosis.[13][14] His thoughts defining delusion perhaps crystallized from the notion of the religion formulations of the common man (circa 1927) as“ ... patently infantile, [so] foreign to reality ...

Why would individuals with religious delusions get a free pass when they form larger groups? Just because ... because, wait let me think ... oh I know! It was thusly decided. So it was written by the Exalted Ones, so shall it be. Lots of things in history were decided to be a certain way for no good reason. So it is with religious delusions Mooby. The psychiatrists are just wrong to make that arbitrary definition. Yes sir - I do have the gall to say that.

Think about about a medical condition like a broken bone. A bone is either broken or it isn't. If one person or ten thousand have broken bones then they have the same problem. The number of people who have the affliction of a broken bone has no bearing on the diagnosis. That's ridiculous.

Why should religious delusions be any different? Obviously, they shouldn't be and that's why Drs. Dawkins and Freud say personal belief in a god is a delusion, and how right they are. Why should intelligent rational thinkers accept an arbitrary definition if it makes no sense? That's like saying large groups of people with broken arms are just a normal societal condition and they don't need any medical attention, but a single person with a broken arm does! That would be absurd!

Your only defence is that The Exalted Ones just, well, said so, it was Decided by the Deciders, and that's that.

As far as diagnosis of medical disorders, psychiatrists are trained as medical doctors, read the psychiatric literature, treat multiple patients with psychiatric disease per day, and are aiming to provide objective treatment to maximize the benefit to the patient. The definition of delusion and the criteria for diagnosis and treatment that they use are set by the American Psychiatric Association (US) or the World Health Organization. In short, they're the experts.

Dawkins is an evolutionary biologist and a critic of theism. He likely has little to no experience with delusional patients and in separating delusion from other conditions. Were he to encounter the patient in your case scenario, he would likely have less precise questions, a shorter differential diagnosis, less accurate documentation, a less accurate assessment, and a less beneficial (and possibly even dangerous) plan. This says nothing against him--he appears to be a very intelligent man--but he lacks the knowledge, experience, and expertise to evaluate patients medically.

Furthermore, the standard definitions set by the APA or WHO are intended to be objective, unbiased definitions. Dawkins makes no effort to hide his bias, proudly displaying it in the title of his book. Thus, it's questionable whether Dawkins was even trying to create a standard medical definition of "delusion," or whether he was simply adopting a definition that suited his specific needs for his book.

Is it possible that Richard Dawkins' definition is a better definition of "delusion" than the one used by the medical community? Of course, just as it's possible that someone who has watched House or Scrubs or MASH could correctly diagnose a condition that their regular doctor missed. But that doesn't mean that either is particularly qualified or reliable to make medical assessments, and if I'm doing any sort of medical literature review there's no way I could ever cite The God Delusion or House as a source. The medical community, like most scientific communities, looks to published, peer reviewed research for sources, not outside publications or opinions.

Yet because of the said free pass, those randomized, controlled studies are never going to happen.

Funny, this reminds me a lot about what some creationists claim about the alleged conspiracy to shield evolution and shun intelligent design. It looks like every ideology has its... erm... members who hold those sort of suspicions.

When deciding whether to alter their approach to religious patients, which specific studies should physicians review?

Firstly by disregarding the free pass, and accepting theism as delusion.

Dodge. I asked "which specific studies," not "by what method."

Unlike ideologues, doctors do not start by disregarding the existing standard of practice and then accepting an idea that fits their ideology without any support from the medical literature. If a doctor were to do this, they might as well start writing some blank checks because they won't have anything to hide behind if they get sued. In the US, at least, we take this stuff seriously as we're gambling with people's lives. This is not a game; psych diagnoses carry a lot of stigma, and treatments can have a lot of side effects. We can't afford to screw people up for life or even potentially kill them over some nut's fanatical conspiracy theory.

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So what. if you can't demonstrate it is real then your only course of action is to see it as imaginary? regardless of your being a doctor or a layman.

I can--and do--reserve judgement. I don't jump to conclusions.

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"In what way can you demonstrate whether that voice is real or imaginary?"

Mooby doesn't care about whether the voices are real or not. He is treating this shindig as though it was a case. A mental health worker doesn't give a rat's ass about the truth of his patients belief. If the delusion is helpful to a persons mental health, you leave it there. Herp derp. Think optimism bias in a person with depression. You don't try to dispel the notions brought about by optimism bias if the person is effin depressed.

To everybody else, you guys care more about the what the mental health worker thinks about the voices. The psychiatrist doesn't really give a shit. Most people believe in bullshit. You, me, even the psychiatrist themselves. We've all got emotions clouding up our judgements. The purpose of the psychiatrist is to see how he can give the person better mental health, not to give him more integrity in his thoughts.

Mooby why does a Christian need to seek a doctor for any medical ailments,be it life threatening or for mental health reasons? Pray and if its God's will you get better then so be it,if you die or go insane....also God's will

I don't know. If they come to me anyways, I do my job. If they stay home, I'll never know about it (or read about it here when it goes terribly wrong and makes the news.)

Mooby doesn't care about whether the voices are real or not. He is treating this shindig as though it was a case.

Yes. I am answering, "My question is, what does the doctor make of this person at this point," not "does the psychiatrist think the voice is real." The patient (or the patient's insurance) is paying the psychiatrist for a service. It's not a psychiatrist's job to make religious speculations about a patient's experiences. Their job is to gather information, assess the patient, and develop a plan based on their medical knowledge and expertise.

Well if all theists are batshit crazy everyone else better go hide out in a bomb shelter. Maybe you all can drink bottled water and get some legislation passed to put some Thorazine in the water to mellow out all of us nutty bible thumpers. Silly me though -- spending all these nursing visits teaching disease management to my patients when according to you I should have just been praying. SERIOUSLY?? Do you really think ALL people who chose not to abandon their beliefs are complete idiots? if you do then you really ARE a BIGOT!

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It doesn't make sense to let go of something you've had for so long. But it also doesn't make sense to hold on when there's actually nothing there.

Mooby why does a Christian need to seek a doctor for any medical ailments,be it life threatening or for mental health reasons? Pray and if its God's will you get better then so be it,if you die or go insane....also God's will

I don't know. If they come to me anyways, I do my job. If they stay home, I'll never know about it (or read about it here when it goes terribly wrong and makes the news.)

Mooby doesn't care about whether the voices are real or not. He is treating this shindig as though it was a case.

Yes. I am answering, "My question is, what does the doctor make of this person at this point," not "does the psychiatrist think the voice is real." The patient (or the patient's insurance) is paying the psychiatrist for a service. It's not a psychiatrist's job to make religious speculations about a patient's experiences. Their job is to gather information, assess the patient, and develop a plan based on their medical knowledge and expertise.

So their faith that the lord will heal them is limited by the fact they may die if they fail to seek treatment? Ye of little faith bwa hahahahahah

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There's no right there's no wrong,there's just popular opinion (Brad Pitt as Jeffery Goines in 12 monkeys)

When deciding whether to alter their approach to religious patients, which specific studies should physicians review?

Firstly by disregarding the free pass, and accepting theism as delusion.

Dodge. I asked "which specific studies," not "by what method."

Ah but you preceded it with (my emphasis). So it is certainly not a dodge, as it was answered with "Firstly by disregarding the free pass" and finished with "accepting theism as delusion" Ie studying delusion.

"In what way can you demonstrate whether that voice is real or imaginary?"

Off-topic.

My first question to you was "So Mooby how would you define the difference between a man who thinks he hears god and a man who hears voices?"Your reply was "my first step would be to determine if it actually involves hearing a physical voice, and then go from there. <snip> So again, even if the person says they're hearing a physical voice, that doesn't necessarily mean it's a hallucination. I think for distinguishing religious experiences the key areas would be content and circumstance: if the voice is mainly heard during prayer/meditation/spiritual exercises and is congruent with the person's religious beliefs, it's probably not a true hallucination. However, if the voice is heard randomly and tells the person to burn things, then that's more likely a true hallucination." too which I replied with "In what way can you demonstrate whether that voice is real or imaginary, if you can't demonstrate it is real then your only course of action is to see it as imaginary?" Which is not off topic as it is going with the context of the conversation, but it has most certainly been dodged, and dodged yet again.

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We theists have no evidence for our beliefs. So no amount of rational evidence will dissuade us from those beliefs. - JCisall

It would be pretty piss poor brainwashing, if the victims knew they were brainwashed, wouldn't it? - Screwtape. 04/12/12

As far as diagnosis of medical disorders, psychiatrists are trained as medical doctors, read the psychiatric literature, treat multiple patients with psychiatric disease per day, and are aiming to provide objective treatment to maximize the benefit to the patient. The definition of delusion and the criteria for diagnosis and treatment that they use are set by the American Psychiatric Association (US) or the World Health Organization. In short, they're the experts.

I don't accept what experts say if it makes no rational sense, so you are going to have a problem trying to cut off my argument telling me "In short, they're the experts."

You haven't said why individuals who would be classified delusional are treated differently when they form a group. As I have already predicted, you merely stated "The Exalted Ones just decided to make it so." So it is written, so shall it be. That's little more than an appeal to common practice, a fallacy.

So sorry moob-ie that don't cut the mustard for me or Dr. Dawkins or Dr. Freud. It's arbitrary and doesn't make sense to a rational thinker. I don't care if they are medical doctors, the arbitrary way they define this is not rational. Them being doctors does not impress me in this argument.

It's not like a broken bone where they can show the objective evidence for their definition in this case. If we were having a medical argument about broken bones and I said show me the evidence this person has a broken bone, you could show the X-ray and we'd take a look and the argument would end. If I say show me the evidence that a group of Christians who talk to god don't suffer a religious delusion, but a single Christian that talks to god does, what would you provide? Nothing. There is nothing you can provide to distinguish between the two. All you can provide is a statement from The Exalted Ones saying it's thus and so, and we'd go round and round.

I can easily argue (and so can Dawkins) that these doctors are wrong to not consider groups of religious people delusional There is no objective measurement they can provide to distinguish a single delusional person from the same delusion in large groups. It's simply an arbitrary cut-off that makes no sense. It's like saying there's so many religious delusional people that we'd better define it away so it magically disappears. Yay - problem solved!

There may be a difference in the mental processes required to adopt and hold a delusion[1] purely on one's own, versus adopting and holding a delusion[2] as a result of social conditioning.

A widely-held delusion would inspire the latter; a less-accepted, "strange" delusion would require the former. If they require different mental processes to come into being and persist, then it makes sense to give them two different names medically - even if, logically, the delusions are precisely on-par with each other.

There may be a difference in the mental processes required to adopt and hold a delusion[1] purely on one's own, versus adopting and holding a delusion[2] as a result of social conditioning.

A widely-held delusion would inspire the latter; a less-accepted, "strange" delusion would require the former. If they require different mental processes to come into being and persist, then it makes sense to give them two different names medically - even if, logically, the delusions are precisely on-par with each other.

Who is "we"? If Mooby is correct about what the doctors say, then "we" as a society do indeed give them different names.

If two different conditions yield the same symptom, then medically, it makes sense to label them differently. If all we're looking at is the surface symptom, then using the same word makes sense. But that's not what the medical community is supposed to do.

Which is fair, from your perspective. From a medical perspective, causes matter. Blindness from alcohol poisoning, and blindness from physical eye damage, are both blindness. But for doctors to give it the same medical label would make little sense.

Which is fair, from your perspective. From a medical perspective, causes matter. Blindness from alcohol poisoning, and blindness from physical eye damage, are both blindness. But for doctors to give it the same medical label would make little sense.

Keep the medical context in mind here, HAL.

Again, I don't care about the cause. I don't care how the delusion was arrived at. I only care that it's a delusion. Talking to invisible unproven entities is a delusion, I agree with Freud and Dawkins. The problem is that religious groups like Christians get a free pass because they seemingly can't be called delusional. I don't agree with that. A delusion is a delusion.

Do you agree, though, that they aren't quite the same in terms of how they reflect on one's mental state?

I don't see how. What's the difference between believing that crackers and wine are the body and blood of a dead guy, believing that an alien overlord blew up a whole bunch of people in volcanoes 75 million years ago, and believing that the moon is inhabited by lizard people who secretly run our planet?

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[On how kangaroos could have gotten back to Australia after the flood]: Don't kangaroos skip along the surface of the water? --Kenn

I agree they're both delusion, just as blindness from alcohol and eye damage are both blindness.

Thank goodness.

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Do you agree, though, that they aren't quite the same in terms of how they reflect on one's mental state?

I have no idea what you mean by "that they aren't quite the same in terms of how they reflect on one's mental state". I don't even know what to answer with respect to a delusional person as compared to a group of delusional persons, such as Christian(s). The delusions they suffer from are many and varied, such as voices heard from god, talking to god, believing in mystical healings, believing in saints, etc. Individuals and groups of Christians both suffer from these delusions.

Now I've attempted to answer your question, can you clearly state your belief so I am sure where you stand -

Do you think Christians are delusional both individually and as a group?

I don't see how. What's the difference between believing that crackers and wine are the body and blood of a dead guy, believing that an alien overlord blew up a whole bunch of people in volcanoes 75 million years ago, and believing that the moon is inhabited by lizard people who secretly run our planet?

I wasn't talking about different delusions. I was talking about different reasons for being delusional.

I have no idea what you mean by "that they aren't quite the same in terms of how they reflect on one's mental state".

What I mean is that the delusion is reached by different paths. The path reflects on the person's mentality. Delusion by means of group conditioning and delusion by means of schizophrenia are both delusions. But they reflect differently on the mental state of the person exhibitin the delusion: One definitely has a biological illness while the other probably does not. Would you suggest treating both people with the same meds?